Clarifying the Impact of South Africa’s New NHI on Medical Aid Members

Clarifying the Impact of South Africa's New NHI on Medical Aid Members

Adrian Gore, CEO of Discovery, has reassured medical aid members that the recent signing of the National Health Insurance (NHI) into law will not affect their cover and benefits for a considerable time.

Gore acknowledged that President Ramaphosa’s approval of the NHI Act has caused anxiety but urged members to focus on the facts. He assured them that Discovery would act in their best interests, the healthcare system, and all South Africans.

The primary cause of concern among South Africans is the potential impact of the new laws on medical aids. Section 33 of the Act, which Gore described as “problematic,” states that once the NHI is fully implemented, medical schemes can only cover services not provided by the NHI.

However, Gore highlighted two reasons why medical aid members should not worry yet. First, the impact of Section 33 will only come into effect once the NHI is fully implemented, which he estimates will take at least a decade due to the scale and complexity of the reforms needed. Second, even after full implementation, medical schemes can still provide cover for benefits not included in the NHI.

Gore noted that the NHI might not have sufficient funding to offer an extensive package of benefits due to the country’s financial constraints. Therefore, medical schemes will continue to play a significant role in post-NHI implementation.

Despite these reassurances, South Africans may still face triple taxation for comprehensive healthcare, including income tax, VAT, NHI surcharges, payroll taxes, and medical aid contributions.

Gore stated that the NHI Act is problematic and unworkable and will face legal challenges. Discovery, along with other groups such as the Democratic Alliance, Solidarity union, and various business and healthcare bodies, are considering or have already initiated legal action against the laws.

Gore emphasized that a successful NHI requires collaboration between the public and private healthcare sectors, which the Act does not adequately facilitate. He stressed the need for more funding, healthcare professionals, and resources, as well as a stronger public sector, for an effective NHI.

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